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Archives of Orthopaedic and Trauma Surgery

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01-11-2020 | Arthroscopy | Arthroscopy and Sports Medicine

Partial resection of the infrapatellar fat pad during anterior cruciate ligament reconstruction has no effect on clinical outcomes including anterior knee pain

Authors: Kazuki Asai, Junsuke Nakase, Takeshi Oshima, Kengo Shimozaki, Rikuto Yoshimizu, Hiroyuki Tsuchiya

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 11/2020

Abstract

Background

Anterior knee pain (AKP) is a major complication that occurs after anterior cruciate ligament reconstruction (ACLR), even when hamstring tendon (HT) grafts are used. Damage to the infrapatellar fat pad (IPFP) during arthroscopy can cause AKP. The purpose of this study was to evaluate the influence of IPFP preservation on clinical outcomes, including AKP, in patients who underwent ACLR with HT autografts using the inside-out technique.

Methods

Forty-two patients who underwent primary ACLR with HT autografts were prospectively assessed for 2 years after surgery. They were randomly selected to undergo treatment with as much intercondylar IPFP preservation as possible or with intercondylar IPFP resection to confirm the ACL origin on the femoral and tibial sides, especially the femoral footprint in deep flexion of the knee joint. The total IPFP volume was calculated using sagittal MR images before and 6 months after surgery. The patients completed a subjective knee score questionnaire and were assessed for patellar tendon tenderness and pain with the half-squat test or single-leg hop test at 6 months and 2 years postoperatively.

Results

There were no differences in the patient characteristics, including age, sex, BMI, time from injury to surgery, and meniscus tear. The difference in the total size of the IPFP preserved was significant (P = 0.004). However, there were no significant differences in the subjective knee scores. Moreover, there were no differences in the clinical assessment parameters between the IPFP preservation and resection groups.

Conclusions

The size of the IPFP decreased more in the resection group than in the preservation group at 6 months after surgery. However, partial IPFP resection, which was used to better visualize the origin of the ACL, had no effect on the clinical outcomes, including AKP.

Level of evidence

Level II.

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Title: Partial resection of the infrapatellar fat pad during anterior cruciate ligament reconstruction has no effect on clinical outcomes including anterior knee pain
Authors: Kazuki Asai
Junsuke Nakase
Takeshi Oshima
Kengo Shimozaki
Rikuto Yoshimizu
Hiroyuki Tsuchiya
Publication date: 01-11-2020
Publisher: Springer Berlin Heidelberg
Keywords: Arthroscopy
Arthroscopy
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 11/2020
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-020-03520-5

At a glance: The STEP trials

Springer Medicine

Partial resection of the infrapatellar fat pad during anterior cruciate ligament reconstruction has no effect on clinical outcomes including anterior knee pain

Abstract

Background

Methods

Results

Conclusions

Level of evidence

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Level of evidence

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